North Carolina added to multistate lettuce-linked Cyclospora investigation. What residents should know

North Carolina is one of 17 states included in a federal investigation of Cyclospora illnesses linked to recalled iceberg lettuce, but the state’s larger increase in cases has not been tied to one confirmed food source.

The immediate consumer point is that recalled Taylor Farms de Mexico iceberg lettuce should no longer be available in North Carolina stores or restaurants. The U.S. Food and Drug Administration says the product’s best-by dates have passed.

What changed in the federal investigation

North Carolina was added to the multistate investigation in the federal update issued Aug. 5. In an Aug. 13 update, the FDA and Centers for Disease Control and Prevention reported 9,481 laboratory-confirmed illnesses, 398 hospitalizations and two deaths across 17 states.

The investigation remains open. Federal officials said most illnesses began before Taylor Farms de Mexico recalled the lettuce on July 17. Additional cases may still be added because it can take as long as six weeks to determine whether a patient’s illness is part of the outbreak.

The FDA and CDC identify iceberg lettuce sourced from central Mexico and recalled by Taylor Farms de Mexico as the source of the ongoing multistate outbreak. That determination is based on epidemiological information and traceback work. FDA records say there are no confirmed positive product-test results for Cyclospora, and the investigation continues.

Recalled lettuce was distributed to North Carolina food-service customers

FDA records show recalled iceberg lettuce products distributed by Taylor Fresh Foods through food-service channels in North Carolina from June 29 through July 16. The recalled products included food-service lettuce supplied to restaurants and other customers.

The recall also covered certain Marketside salad and shredded-lettuce products sold at select Walmart stores in other states. The FDA and CDC say the affected best-by dates have passed and recalled lettuce should no longer be on sale or in restaurants.

Consumers who previously received recalled lettuce should not eat it. They should carefully clean and sanitize surfaces and containers the product touched. Restaurants and retailers should follow federal food-safety guidance and cooperate with health officials if contacted.

North Carolina’s case increase is broader than the federal outbreak

The federal outbreak count should not be treated as the total number of North Carolina cases. The North Carolina Department of Health and Human Services dashboard reported 906 cases since May 2026 and 31 hospitalizations as of Aug. 11. Wake County residents accounted for 508 of those cases.

NCDHHS uses a state reporting methodology that includes cases identified through positive laboratory testing or through compatible illness and a known exposure. Federal officials are reporting laboratory-confirmed cases for the multistate investigation, so the figures are not directly interchangeable.

NCDHHS said it is working with state and local partners to identify the source of the broader increase. The agency said the North Carolina increase does not currently appear associated with the earlier Taco Bell-linked outbreak. Recent North Carolina patients reported eating parsley and cilantro more often than expected, but NCDHHS has not identified either food as a confirmed source.

Residents should not assume that lettuce, parsley, cilantro or any other single food caused the statewide increase. The CDC also says it is investigating other national cyclosporiasis illnesses and outbreaks that may be unrelated to the recalled-lettuce outbreak.

Symptoms can last weeks or return

Common symptoms of cyclosporiasis include watery or frequent diarrhea, loss of appetite, weight loss, stomach cramps, bloating, increased gas, nausea and fatigue. Symptoms may improve and then return, and untreated illness can last a month or longer.

People with persistent or recurring diarrhea should contact a health care provider and ask whether Cyclospora-specific testing is appropriate. Routine stool tests do not always screen for the parasite. Staying hydrated is important because diarrhea can cause dehydration and more serious complications. People with dehydration concerns, prolonged illness or compromised immune systems should seek medical care.

What happens next

The FDA has begun an on-site inspection and sampling at Taylor Farms de Mexico in coordination with Mexican officials. Federal, state and local health agencies are continuing case interviews, traceback work and updates to distribution and illness information.

For North Carolina residents, two investigations need to be kept separate: the federal lettuce-linked outbreak that includes the state, and the larger state increase whose single source remains unknown.

Sources

• FDA multistate Cyclospora investigation: iceberg lettuce, July 2026
• CDC Cyclospora outbreak linked to iceberg lettuce
• NCDHHS Cyclosporiasis Cases in North Carolina dashboard

Look for updates to this story

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